The practice of law is a stressful profession. Meeting deadlines, responding to client demands, managing conflicting priorities, satisfying billing goals, and maintaining high professional standards are inherent to law practice. These stressors contribute to high rates of depression, problematic substance use, behavioral addictions, and other stress-induced conditions among lawyers. Chronic stress can further lead to heart disease, cancer, diabetes, rheumatoid arthritis, stroke, and other life-threatening diseases.
Stress avoidance, however, is impractical in the modern world and impossible in the legal field. The good news is that stress, in and of itself, is not necessarily harmful and can be very valuable. With simple stress-relief tools and self-care practices, we can learn to channel stress effectively, benefit from its positive aspects, and reduce the negative impact on our health and well-being.
Research has consistently found that stigma–or the fear of stigma–frequently prevents people from seeking the help they need. One study found that people will suffer from their symptoms for up to ten years before seeking help, largely because of stigma. Yet we know that getting people the help they need earlier leads to better long-term outcomes for everyone involved.
LCL provides free and confidential help to lawyers, judges, law students, and their immediate families with any issue causing them stress or distress in their life.
Depression is a mood disorder that also affects our body and thoughts. Depression is not a blue mood that passes after a few hours or days. It interferes with one’s ability to work, study, sleep, eat, and enjoy once pleasurable activities. An episode may occur only once, but more commonly returns several times in a lifetime. Often, the symptoms occur in stages. For instance, feelings of sadness will precede the empty feeling which reflects an absence of feelings. This is followed by a feeling of helplessness or hopelessness, which is often followed by thoughts of death or suicide. Some describe it as walking through water with weights around your ankles.
In our profession, we are reluctant to seek help for depression because we don’t want to be seen as weak. It’s important to recognize that this is an illness as deserving of medical attention as diabetes or a tumor. While there are several symptoms (listed below), lawyers tend to ask for help when work is affected because of difficulty concentrating, remembering, or deciding.
- Persistent sad, anxious, or “empty” (absence of feelings) mood
- Feelings of hopelessness and pessimism
- Loss of interest or pleasure in activities we once enjoyed, e.g. sex
- Feelings of guilt, worthlessness, helplessness
- Decreased energy, fatigue, being “slowed down”
- Difficulty concentrating, remembering, making decisions
- Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain
- Insomnia, early-morning awakening, or oversleeping
- Restlessness, irritability
- Decreased appetite and/or weight loss, or overeating and weight gain
- Thoughts of death or suicide, having a plan, or suicide attempt(s) If this symptom is present, call 911 or seek medical help immediately.
Treatment for Depression
Most people diagnosed with depression will find the most relief from a combination of medications and therapy. Medications can help resolve symptoms, but they won’t change the underlying causes. Appropriate therapy, available in both individual and group settings, is critical to returning to a better life. Support is also a key component of recovery. LCL’s counseling partner, Sand Creek, can provide an initial evaluation and appropriate referrals at no cost to you.
The Lawyers with Depression website was created by an attorney to help others with the same illness. It includes a frequently updated blog, recommended resources, and many guest articles.
- American Psychological Association
- National Alliance on Mental Illness and Minnesota NAMI
- Anxiety and Depression Association of America
- Depression and Bipolar Support Alliance
- What is Depression? – National Institute of Mental Health
- Dave Nee Foundation (Depression and Suicide, Law Students and Lawyers)
- A recent William Mitchell Law Review Article (Vol. 41, Issue 3) discusses stigma and mental illness.
- Suicide Prevention Information
Anxiety may be experienced in many ways. Someone who worries excessively over a long period may be experiencing Generalized Anxiety Disorder (GAD), an anxiety disorder characterized by chronic anxiety, exaggerated worry, and tension. This may occur even when there is little or nothing obvious to provoke it. Some of the symptoms are irritability, inability to concentrate, fatigue, and muscle tension. The worry or concern may be about family issues, career issues, financial or job security, and other concerns. The person experiencing general anxiety will often have a greatly reduced quality of life.
Anxiety can also occur as a phobia which is a reaction triggered by a specific situation or event. For some legal professionals, it will manifest as a social phobia related to performing or being evaluated. For these individuals, symptoms will include heart pounding, sweating, or blushing, and this can have a devastating effect on one’s career. People experiencing phobias often isolate themselves and are prone to depression.
Another form of anxiety is panic attacks. These may strike without warning, at any time. They are characterized by a sense of impending doom and loss of control along with the physical symptoms that can be triggered by a phobia. The attacks are generally short-lived, but those who have had one are at greater risk of having another.
Obsessive-Compulsive Disorder is a form of anxiety characterized by persistent, upsetting thoughts (obsessions) and rituals (compulsions) used to control the anxiety these thoughts produce. When this becomes a problem, it’s because the rituals end up controlling the individual.
Post-traumatic stress disorder (PTSD) is anxiety that develops after a terrifying ordeal that involved physical harm or the threat of physical harm. Symptoms include loss of trust, hyper-vigilance, and isolation. A person who develops PTSD may have been the one who was harmed, the harm may have happened to a loved one, or the person may have witnessed a harmful event that happened to someone else.
Learning from Anxiety
The experience of anxiety is unpleasant, but ultimately it is there to help us. From the beginning of time, our brain has been alert to potential threats. When one is identified (ranging from true danger to an angry opposing counsel), we react. This “flight or fight” response may trigger the physical symptoms listed above in addition to sweaty palms, hyper-alertness, and a rapid heart rate. A little bit of anxiety can help us perform better, but if it starts to affect your ability to perform and threatens to impede your professional or personal growth, there’s a problem. It’s time to get help.
Treatment for Anxiety
Medications can be the first line of defense against anxiety symptoms, but they won’t change the underlying causes. Appropriate therapy, available in both individual and group settings, is critical to returning to a better life. LCL’s counseling partner, Sand Creek, can provide an initial evaluation and appropriate referrals at no cost to you.
- National Institute of Mental Health information
- Lawyers and Anxiety: Three Case Studies
- Wisconsin Lawyer Assistance Program’s Study on Compassion Fatigue
- North Carolina Lawyer Assistance Program’s Article on Lawyers and Anxiety
- American Psychological Association
- National Alliance on Mental Illness and Minnesota NAMI
- Anxiety and Depression Association of America
- Help Yourself. Help Others.
What is stress? Stress is your body’s way of responding to a demanding situation, such as:
- working on a high-stakes case
- working on a boring case
- having to beat various deadlines
- responding to a professional ethics complaint
- resolving an interpersonal conflict
- answering to an unreasonable client
- financial worries
- getting fired or being laid off
Stress induces a “fight or flight” response where your heart rate increases, blood pressure rises, and adrenaline gets pumped into the blood. Non-essential functions like digestion, cell repair, and reproduction either cease or operate at a much-reduced level, allowing more energy to be diverted to the fight or flight response. Within a very short time, the body burns the adrenaline and other chemicals and returns to a normal, non-threatened state. At least that’s how our bodies evolved to act–stress marshalls our bodies’ resources to perform at peak levels because our survival depends on it.
In most cases, a judge, lawyer, or law student who experiences stress will not be able to run away or fight the source of the stress. Ongoing, psychological factors, instead of life-or-death situations, also tend to be the main triggers of stress. Because the stress-response system was not really designed for these situations, adrenaline and other chemicals are left unburned in the body. If left unchecked, stress can cause the body to experience a systemic breakdown in the digestive, circulatory, pulmonary, and immune systems, resulting in major health problems.
When is stress good for you?
Short-term, or acute, stress is a natural and welcome response to a real demand or an imagined threat. It can enhance creativity, heighten productivity, increase resilience, improve memory retention, sharpen focus, and boost energy. When kept in check, stress helps you perform at your optimum levels.
When is stress bad for you?
When stress becomes chronic, it becomes difficult for the body to return to a balanced state. Long-term stress can lead to fatigue, loss of efficiency, decreased productivity, higher rates of depression, anxiety and burnout, physical illness, and life-threatening diseases.
What are the signs of chronic stress?
Pay attention to the warning signs of stress so it does not impair your overall health and wellness. Mastering stress begins with recognizing the physical, mental, and behavioral symptoms, which include:
- Frequent colds
- Loss of appetite
- Stomach upset
- Inability to sleep or insomnia
- Lack of concentration
- Various aches and pains
- Marital dissatisfaction and discord
- Family conflicts
- Career dissatisfaction
- Mental or physical breakdown
- Problematic use of alcohol or other drugs
- Increased involvement with gambling, sex or other addictive activities
Sand Creek offers a website with comprehensive materials and resources on a wide range of issues. Click on the “MY LIFE EXPERT LOGIN” button to log in or create your new account. When creating your new account, use the Company Code “lawyers.”
Bipolar Disorder is also called manic depression. It occurs less frequently than depression but can be very serious. It is characterized by cycling mood changes from extreme elation (mania) to depression. Most often the mood change is gradual. The depressive condition is like major depression. A manic period affects thinking, judgment, and social behavior and may lead to grand romantic or business schemes that create serious problems and embarrassment. Untreated mania can lead to a psychotic state. Symptoms include:
- Increased energy, activity, and restlessness
- Excessively “high,” overly good, euphoric mood
- Extreme irritability
- Racing thoughts and talking very fast, jumping from one idea to another
- Distractibility, inability to concentrate or stay focused
- Lack of need for sleep
- Unrealistic beliefs in one’s abilities and powers
- Poor judgment
- Spending sprees
- Problematic use of drugs, particularly cocaine, alcohol, and sleeping medications
- Provocative, intrusive, or aggressive behavior
- Denial that anything is wrong
The resistance to treatment for Bipolar Disorder is two-fold. When an individual is in an extreme manic state, they may feel invincible, will deny there is a problem, and are very difficult to reach. The low manic state includes a feeling of euphoria and well-being. The individual will actually be more creative and productive, and he or she will know that with proper treatment, they are not likely to be able to revisit this stage. Understandably, there is a reluctance to lose this sense of well-being, even though a more difficult stage is imminent.
Bipolar Disorder is often treated with medications (mood stabilizers, anti-psychotic medications, or antidepressants). Psychotherapy and sometimes electroconvulsive therapy are utilized. Support is also a key component of recovery. LCL’s counseling partner Sand Creek can provide an initial evaluation and appropriate referrals at no cost to you.
Resources for Bipolar Disorder
ADD/ADHD is a neurobiological condition that affects individuals across the lifespan. While it’s generally thought of as a children’s condition, many adults who have the disorder are not aware of it. Rather, they feel inadequate because of an inability to get and stay organized, be successful in a job, or remember and track details and appointments. There may be a history of doing things at the last minute and trying to do many things at once, often unsuccessfully. Executive functions are affected and need to be managed. A strategic plan for success seems daunting and overwhelming. One of the biggest challenges is a shame-based distortion that everyone else “has it all together.” Signs and symptoms include:
- Low self-esteem
- Incomplete projects
- Chronic lateness
- Interrupting others
- Losing things
- Hyper focus
An individual with ADD/ADHD can have areas of success in law because of some of these factors. Because of hyper focus, if there is interest, a large amount of work can be completed in a short period of time. One attorney with ADHD said “People with ADHD can really think deeply about subjects we have interest in and make creative leaps and unique connections. I’m good at ‘thinking outside the box’, seeing connections others may not, and coming up with unique arguments and/or solutions to problems.”
Resources for ADD/ADHD
- National Institute of Mental Health
- Learning Disabilities Association of Minnesota – click on Attention Deficit Support Services
- Attention Deficit Disorder Association
- Children and Adults with Attention-Deficit/Hyperactivity Disorder
An eating disorder is an illness where an individual has an unhealthy obsession with food, weight, and body image, and he or she engages in maladaptive behaviors in an attempt to control caloric intake and weight. A person suffering from an eating disorder has a distorted body image, seeing themself as “fat” no matter how emaciated the individual becomes. You cannot always “see” an eating disorder because it is often a silent killer. The individual may look perfectly healthy by all outward appearances. While eating disorders may begin with preoccupations with food and weight, they are often about much more than food. People with eating disorders may be reluctant to ask for help for a variety of reasons, but it’s important to note that help is available. LCL can provide counseling, assessment, and referrals to other resources.
Eating Disorders are Illnesses
An eating disorder is much more than just being on a diet. They are not a “fad” or a “phase.” People do not “catch” an eating disorder for a period of time. An eating disorder is a disease with profound effects on those with the illness and those who care about them.
Eating disorders are extremely dangerous and need immediate treatment. Eating disorders have the highest mortality rate of any mental illness. The National Eating Disorder Awareness and the National Institute of Mental Health recommend that any person with an eating disorder seek treatment right away.
Types of Eating Disorders
There are four (4) known diagnoses of eating disorders:
- Anorexia Nervosa
- Bulimia Nervosa
- Eating Disorder Not-Otherwise-Specified
- Binge Eating
The four mentioned eating disorders are not all-inclusive. Other types of eating disorders include diabulimia and orthorexia. The DSM (Diagnostic and Statistical Manual of Mental Disorders) lists all the factors that are evaluated by medical professionals.
There are severe medical complications associated with eating disorders. As previously stated, eating disorders have the highest mortality rates of all mental health illnesses.
The most common associated dangers include malnutrition, dehydration, electrolyte imbalances, hyponatremia, gastroparesis, sinus bradycardia, and refeeding syndrome. The “common dangers” are only symptoms of the damage being caused to the internal systems of the body. Eating disorders result in severe medical issues which include, but are not limited to, kidney failure, heart attacks, osteoporosis, fatty liver syndrome, and ultimately death.
These are some helpful websites to get more information about eating disorders:
- ANAD – National Association of Anorexia Nervosa and Associated Disorders, Inc.
- National Institute of Mental Health
- National Eating Disorder Awareness – The National Eating Disorders Association (NEDA) is the leading non-profit organization in the United States advocating on behalf of and supporting individuals and families affected by eating disorders.
- Eating Disorders Online – This is an amalgamation of articles and resources
- Eating Disorder Hope offers education, support, and inspiration to eating disorder sufferers, their loved ones, and eating disorders treatment providers.
Many people find help in 12-step based programs such as:
These are some of the available treatment options in Minnesota. Please keep in mind that this list is not exhaustive and does not indicate a recommendation. LCL also refers to programs outside of Minnesota.
Alzheimer’s Disease is the most common form of dementia. It destroys brain cells and causes problems with memory, thinking, and behavior that are severe enough to affect work, lifelong hobbies, or the individual’s social life. It is progressive and incurable. Ten of the most common warning signs are:
- Memory loss
- Difficulty performing familiar tasks
- Problems with language
- Disorientation to time and place
- Poor or decreased judgment
- Problems with abstract thinking
- Misplacing things
- Changes in mood or behavior
- Changes in personality
- Loss of initiative
While most people will have some memory changes as they age, there is a clear distinction between normal age-related memory changes and Alzheimer’s disease symptoms. Someone with normal memory loss may forget part of an experience yet recall things later, can usually follow written or spoken direction, can use notes for reminders, and can care for him or herself. The person with Alzheimer’s symptoms will forget entire experiences and rarely remember later. He or she cannot follow directions, won’t understand written reminders, and will be gradually unable to care for him or herself.
Lawyers experiencing signs of dementia may deny the problem, yet they can make mistakes or neglect matters which results in harm to clients. Sensitive and respectful intervention is needed to help the lawyer retire with dignity. LCL can be a resource.